Global, regional, and national mortality due to unintentional carbon monoxide poisoning, 2000–2021: results from the Global Burden of Disease Study 2021
Authors: Madeline E Moberg, Erin B Hamilton, Scott M Zeng, Dana Bryazka, Jeff T Zhao, Rachel Feldman, Yohannes Habtegiorgis Abate, Mohsen Abbasi-Kangevari, Ame Mehadi Abdurehman, Aidin Abedi, Eman Abu-Gharbieh, Isaac Yeboah Addo, Abiola Victor Adepoju, Qorinah Estiningtyas Sakilah Adnani, Saira Afzal, Bright Opoku Ahinkorah, Sajjad Ahmad, Danial Ahmed, Haroon Ahmed, Dejene Tsegaye Alem, Adel Ali Saeed Al-Gheethi, Yousef Alimohamadi, Edward Kwabena Ameyaw, Mohammad Amrollahi-Sharifabadi, Tadele Fentabil Anagaw, Anayochukwu Edward Anyasodor, Jalal Arabloo, Aleksandr Y Aravkin, Seyyed Shamsadin Athari, Alok Atreya, Amirhossein Azari Jafari, Ashish D Badiye, Nayereh Baghcheghi, Sara Bagherieh, Hansi Bansal, Amadou Barrow, Azadeh Bashiri, Nebiyou Simegnew Bayileyegn, Alemshet Yirga Berhie, Akshaya Srikanth Bhagavathula, Pankaj Bhardwaj, Archith Boloor, Luis Alberto Cámera, Felix Carvalho, Márcia Carvalho, Eeshwar K Chandrasekar, Jung-Chen Chang, Vijay Kumar Chattu, Dinh-Toi Chu, Kaleb Coberly, Natália Cruz-Martins, Omid Dadras, Xiaochen Dai, Reza Darvishi Cheshmeh Soltani, Saswati Das, Subasish Das, Sisay Abebe Debela, Berecha Hundessa Demessa, Xinlei Deng, Abebaw Alemayehu Desta, Belay Desye, Meghnath Dhimal, Mahmoud Dibas, Haneil Larson Dsouza, Michael Ekholuenetale, Iman El Sayed, Waseem El-Huneidi, Daniel Berhanie Enyew, Adeniyi Francis Fagbamigbe, Ali Fatehizadeh, Syeda Anum Fatima Fatima, Florian Fischer, Richard Charles Franklin, Tushar Garg, Tilaye Gebru Gebi, Urge Gerema, Melaku Getachew, Motuma Erena Getachew, Farhad Ghamari, Mahaveer Golechha, Pouya Goleij, Sapna Gupta, Veer Bala Gupta, Vivek Kumar Gupta, Mehdi Harorani, Hamidreza Hasani, Abbas M Hassan, Hossein Hassanian-Moghaddam, Mohammed Bheser Hassen, Simon I Hay, Khezar Hayat, Mohammad Heidari, Mahsa Heidari-Foroozan, Demisu Zenbaba Heyi, Ramesh Holla, Praveen Hoogar, Md Shakhaoat Hossain, Mohammad-Salar Hosseini, Sorin Hostiuc, Soodabeh Hoveidamanesh, Olayinka Stephen Ilesanmi, Irena M Ilic, Mustapha Immurana, Chidozie C D Iwu, Umesh Jayarajah, Nitin Joseph, Charity Ehimwenma Joshua, Vidya Kadashetti, Tanuj Kanchan, Himal Kandel, Rami S Kantar, Neeti Kapoor, Ibraheem M Karaye, Patrick DMC Katoto, Himanshu Khajuria, Ejaz Ahmad Khan, Sorour Khateri, Farzad Khodamoradi, Moein Khormali, Jagdish Khubchandani, Grace Kim, Adnan Kisa, Hamid Reza Koohestani, Kewal Krishan, Naveen Kumar, Lucie Laflamme, Iván Landires, Bagher Larijani, Paolo Lauriola, Thao Thi Thu Le, Caterina Ledda, Seung Won Lee, Stephen S Lim, Stany W Lobo, Raimundas Lunevicius, Sandeep B Maharaj, Ritesh G Menezes, Alexios-Fotios A Mentis, Tomislav Mestrovic, Ted R Miller, Seyyedmohammadsadeq Mirmoeeni, Awoke Misganaw, Manish Mishra, Sanjeev Misra, Chaitanya Mittal, Esmaeil Mohammadi, Ali H Mokdad, Mohammad Ali Moni, Ebrahim Mostafavi, Sumaira Mubarik, Francesk Mulita, Jember Azanaw Mulualem, Temesgen Mulugeta, Christopher J L Murray, Isabella Myers, Biswa Prakash Nayak, Vinod C Nayak, Seyed Aria Nejadghaderi, Huong Lan Thi Nguyen, Van Thanh Nguyen, Hasti Nouraei, Ogochukwu Janet Nzoputam, Hassan Okati-Aliabad, Isaac Iyinoluwa Olufadewa, Michal Ordak, Alicia Padron-Monedero, Jagadish Rao Padubidri, Ashok Pandey, Suman Pant, Utsav Parekh, Shrikant Pawar, Amy E Peden, Ionela-Roxana Petcu, Frédéric B Piel, Zahra Zahid Piracha, Ghazaleh Pourali, Ibrahim Qattea, Maryam Faiz Qureshi, Pankaja Raghav Raghav, Mosiur Rahman, Shayan Rahmani, Premkumar Ramasubramani, Sheena Ramazanu, Salman Rawaf, Nazila Rezaei, Negar Rezaei, Mohsen Rezaeian, Basema Saddik, Malihe Sadeghi, Farideh Sadeghian, Umar Saeed, Amirhossein Sahebkar, Zahra Saif, Joseph W Sakshaug, Saina Salahi, Payman Salamati, Abdallah M Samy, Rodrigo Sarmiento-Suárez, David C Schwebel, Subramanian Senthilkumaran, Allen Seylani, Masood Ali Shaikh, Sunder Sham, Bereket Beyene Shashamo, Rahim Ali Sheikhi, B Suresh Kumar Shetty, Pavanchand H Shetty, Migbar Mekonnen Sibhat, Harpreet Singh, Paramdeep Singh, Eskinder Ayalew Sisay, Yonatan Solomon, Majid Taheri, Irfan Ullah, Sana Ullah, Francesco S Violante, Linh Gia Vu, Nuwan Darshana Wickramasinghe, Arzu Yigit, Naohiro Yonemoto, Zabihollah Yousefi, Muhammad Zaman, Mikhail Sergeevich Zastrozhin, Zhi-Jiang Zhang, Peng Zheng, Mohammad Zoladl, Jaimie D Steinmetz, Theo Vos, Mohsen Naghavi, Kanyin Liane Ong
Journal: The Lancet Public Health (2023)

<h2>Summary</h2><h3>Background</h3> Unintentional carbon monoxide poisoning is a largely preventable cause of death that has received insufficient attention. We aimed to conduct a comprehensive global analysis of the demographic, temporal, and geographical patterns of fatal unintentional carbon monoxide poisoning from 2000 to 2021. <h3>Methods</h3> As part of the latest Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), unintentional carbon monoxide poisoning mortality was quantified using the GBD cause of death ensemble modelling strategy. Vital registration data and covariates with an epidemiological link to unintentional carbon monoxide poisoning informed the estimates of death counts and mortality rates for all locations, sexes, ages, and years included in the GBD. Years of life lost (YLLs) were estimated by multiplying deaths by remaining standard life expectancy at age of death. Population attributable fractions (PAFs) for unintentional carbon monoxide poisoning deaths due to occupational injuries and high alcohol use were estimated. <h3>Findings</h3> In 2021, the global mortality rate due to unintentional carbon monoxide poisoning was 0·366 per 100 000 (95% uncertainty interval 0·276–0·415), with 28 900 deaths (21 700–32 800) and 1·18 million YLLs (0·886–1·35) across all ages. Nearly 70% of deaths occurred in males (20 100 [15 800–24 000]), and the 50–54-year age group had the largest number of deaths (2210 [1660–2590]). The highest mortality rate was in those aged 85 years or older with 1·96 deaths (1·38–2·32) per 100 000. Eastern Europe had the highest age-standardised mortality rate at 2·12 deaths (1·98–2·30) per 100 000. Globally, there was a 53·5% (46·2–63·7) decrease in the age-standardised mortality rate from 2000 to 2021, although this decline was not uniform across regions. The overall PAFs for occupational injuries and high alcohol use were 13·6% (11·9–16·0) and 3·5% (1·4–6·2), respectively. <h3>Interpretation</h3> Improvements in unintentional carbon monoxide poisoning mortality rates have been inconsistent across regions and over time since 2000. Given that unintentional carbon monoxide poisoning is almost entirely preventable, policy-level interventions that lower the risk of carbon monoxide poisoning events should be prioritised, such as those that increase access to improved heating and cooking devices, reduce carbon monoxide emissions from generators, and mandate use of carbon monoxide alarms. <h3>Funding</h3> Bill & Melinda Gates Foundation.